NPIMap

Organization Active NPI

Professional Dental Associates PC

  • Periodontics
  • Astoria, NY
National Provider Identifier
1306915822
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
046368 Issued in NY
Legal business name
PROFESSIONAL DENTAL ASSOCIATES PC
Practice address
3119 Newtown Ave
Suite 800
Astoria, NY 11102-1350
Phone
(718) 728-8844
Fax
(718) 728-6795
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bernard G Rupnarain, DDS MSDNPI 1922421049
Title
President
Phone
(718) 728-8844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 043622 NY
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 046368 NY Primary

Addresses

Primary practice location

3119 Newtown Ave
Suite 800
Astoria, NY 11102-1350

Mailing address

3119 Newtown Ave
Suite 800
Astoria, NY 11102-1350
Phone (718) 728-8844

National Provider Directory

National Provider Directory

Locations

3119 Newtown Ave
Ste 800
Astoria, NY 11102
Phone (718) 728-8844

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1306915822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3119 NEWTOWN AVE",
            "address_2": "SUITE 800",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021350",
            "telephone_number": "718-728-8844",
            "fax_number": "718-728-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 NEWTOWN AVE",
            "address_2": "SUITE 800",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021350",
            "telephone_number": "718-728-8844",
            "fax_number": "718-728-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "RUPNARAIN",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-728-8844",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043622",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "046368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.